Treatment of incisional hernias by placement of an intraperitoneal prosthesis: a series of 128 patients

Summary

This is a retrospective study on 128 patients who underwent surgery between 1986 and 1996 for incisional hernia repair with placement of an intraperitoneal prosthesis. A polyester mesh (Mersilene®) was used in 95 cases (74.2%) and one of PTFE in 33 cases (25.8%). Mortality was 2.34% (3 patients); 32 patients (25.6%) developed an early postsurgical complication. Overall morbidity was 3.9% (3 cases of postoperative pneumonopathy, one case of decompensated asthma, and one of sural vein phlebitis). Three (2.34%) early intra-abdominal complications occurred, manifest as an intestinal obstruction or postsurgical ileus. Seven patients (5.6%) developed a non-infectious abdominal wall complication, and 17 (13.6%) experienced an infectious abdominal wall complication which in 5 cases (29.4%) required surgery with removal of the prosthesis in 3 cases (60%). One patient (0.78%) developed a late small intestine obstruction, 18 months after the incisional hernia repair. Twenty patients (16%) had a recurrence and 22 (17.6%) complained of abdominal wall pain at an interval after the operation. The investigators concluded that placement of an intraperitoneal prosthesis should be reserved only for those cases in whom placement of an extraperitoneal prosthesis cannot be performed.